Medical Forms

Ridley School District Health Policies

• Private Physician Report
• Health History
• Healthy History with Permission and Explanation of Services
• Dental Form
• New Immunization Policy for 2017/2018 School Year

FOR ATTENDANCE IN ALL GRADES CHILDREN NEED THE FOLLOWING:

• 4 doses of tetanus, diphtheria, and acellular pertussis* (1 dose on or after the 4th birthday)
• 4 doses of polio (4th dose on or after 4th birthday and at least 6 month after previous dose given)**
• 2 does of measles, mumps, rubella***
• 3 doses of hepatitis B
• 2 doses of varicella (chickenpox) or evidence of immunity

*Usually given as DTP or DTaP or if medically advisable, DT or Td
**A fourth dose is not necessary if the third dose was administered at age 4 years or older and at least 6 months after the previous dose.
***Usually given as MMR

ON THE FIRST DAY OF SCHOOL:

• If a child does not have all the doses listed above, needs additional doses, and the next dose is medically appropriate, the child must receive that dose within the first five days of school or risk exclusion. If the next dose is not the final dose of the series, the child must also provide a medical plan (red and white card) within the first five days of school for obtaining the required immunizations or risk exclusion.
• If a child does not have all the doses listed above, needs additional doses, and the next dose is not medically appropriate, the child must provide a medical plan (red and white card) within the first five days of school for obtaining the required immunizations or risk exclusion.
• The medical plan must be followed or risk exclusion.

FOR ATTENDANCE IN THE 7TH GRADE:

• 1 dose of tetanus, diphtheria, acellular pertussis (Tdap) on the first day of 7th grade
• 1 dose of meningococcal conjugate vaccine (MCV) on the first day of 7th grade

The Archdiocese of Philadelphia does not allow exemptions for religious belief or philosophical/strong moral or ethical conviction. If your child is exempt for medical reasons, he/she may be excluded from school during an outbreak of vaccine preventable disease.